A farmhouse destroyed by fire. A body amongst the ruins. Dr Kay Scarpetta, Chief Medical Examiner and consulting pathologist for the federal law enforcement agency ATF, is called out to a farmhouse in Virginia which has been destroyed by fire. In the ruins of the house she finds a body which tells a story of a violent and grisly murder. The fire has come at the same time as another, even more incendiary horror: Carrie Grethen, a killer who nearly destroyed the lives of Scarpetta and those closest to her, has escaped from a forensic psychiatric hospital.